Y-V flap anal canaloplasty

YV flap anal angioplasty is used for the surgical treatment of anorectal stenosis. Anorectal stenosis refers to the narrowing of the anus, anal canal, and rectal cavity, which makes it difficult to defecate. There are many reasons for stenosis, including congenital defects, injuries, and inflammation. Such as stenosis caused by internal hemorrhoids injection, excessive skin resection, high anal fistula surgery, rectal anastomosis and perianal cloning, especially anorectal surgery, scar contracture caused by treatment, fibrous tissue proliferation Stenosis is more common. Anal canal stenosis can be divided into 3 degrees: mild: the anal canal is tight, but can be passed through the index finger or medium Hill-Fergusson retractor. Moderate: The index finger and the medium-sized Hill-Fergusson retractor cannot enter the anal canal. Severe: The little finger and the small Hill-Fergusson retractor cannot enter the anal canal. Rectal stenosis is divided into three categories according to its shape: 1 annular stenosis: the rectal cavity is reduced from the periphery to the inside, forming a ring, the rectum longitudinal diameter <2.5cm; 2 tubular stenosis: the rectum longitudinal diameter is above 2.5cm, into a tubular shape; Narrow: It is a part of the rectal cavity that narrows and does not affect the entire lumen of the intestine. Treatment of diseases: anal canal, rectum, colon stenosis Indication YV flap anal angioplasty is suitable for anal canal stenosis or scar contracture below the tooth line. Contraindications Inflammation of the perianal area should be postponed. Preoperative preparation 1. Diet: 3 to 5 days before surgery into the semi-liquid, 1 ~ 2d before surgery clear fluid. 2. Laxatives: 3 days before surgery, take 25% magnesium sulfate 30ml or castor oil 30ml per night. 3. Enema: 3 days before surgery, saline enema once a night, clean the enema before surgery. 4. Oral antibiotics: one of the following options can be selected: 1 neomycin 1g, erythromycin 0.5g, 1d 8th, 14h, 18h and 22 hours before surgery; 2 kanamycin 1 g, metronidazole 0.4 g, 3 days before surgery, 3 times a day. 5. Other drugs: Vitamin K 4 ~ 8mg, 4 times a day. 6. The perianal skin is shaved. Surgical procedure 1. Longitudinal incision of a narrow annular scar with an electric knife. 2. The right finger is inserted above the stenosis ring, and the anus outside the anus is examined for one week to understand the degree and extent of the stenosis. Separate scars on both sides of the incision. 3. Make a V-shaped incision at the outer end of the longitudinal incision to make the wound into a Y shape. 4. Free Y-shaped full-thickness flap (which may include partial scars). After sufficient separation, pull the tip of the flap to the tip of the incision. 5. Use 2-0 absorbable thread and fine non-absorbent line, suture the mucosa and skin intermittently, and form a V-shaped wound. Make the same VY-shaped cut in front if necessary. 6. Disinfect the wound, press the wound with dry gauze, and fix it with gauze. complication Skin flap infection and necrosis are the main causes of surgical failure, and attention should be paid to prevention.